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J Allergy Clin Immunol. 2012 May;129(5):1334-1342.e1. doi: 10.1016/j.jaci.2012.02.038. Epub 2012 Apr 3.

Relationship between red meat allergy and sensitization to gelatin and galactose-α-1,3-galactose.

Author information

1
John James Medical Centre, Deakin, Australia; Medical School, Australian National University, Canberra, Australia. rmullins@allergycapital.com.au

Abstract

BACKGROUND:

We have observed patients clinically allergic to red meat and meat-derived gelatin.

OBJECTIVE:

We describe a prospective evaluation of the clinical significance of gelatin sensitization, the predictive value of a positive test result, and an examination of the relationship between allergic reactions to red meat and sensitization to gelatin and galactose-α-1,3-galactose (α-Gal).

METHODS:

Adult patients evaluated in the 1997-2011 period for suspected allergy/anaphylaxis to medication, insect venom, or food were skin tested with gelatin colloid. In vitro (ImmunoCAP) testing was undertaken where possible.

RESULTS:

Positive gelatin test results were observed in 40 of 1335 subjects: 30 of 40 patients with red meat allergy (12 also clinically allergic to gelatin), 2 of 2 patients with gelatin colloid-induced anaphylaxis, 4 of 172 patients with idiopathic anaphylaxis (all responded to intravenous gelatin challenge of 0.02-0.4 g), and 4 of 368 patients with drug allergy. Test results were negative in all patients with venom allergy (n = 241), nonmeat food allergy (n = 222), and miscellaneous disorders (n = 290). ImmunoCAP results were positive to α-Gal in 20 of 24 patients with meat allergy and in 20 of 22 patients with positive gelatin skin test results. The results of gelatin skin testing and anti-α-Gal IgE measurements were strongly correlated (r = 0.46, P < .01). α-Gal was detected in bovine gelatin colloids at concentrations of approximately 0.44 to 0.52 μg/g gelatin by means of inhibition RIA.

CONCLUSION:

Most patients allergic to red meat were sensitized to gelatin, and a subset was clinically allergic to both. The detection of α-Gal in gelatin and correlation between the results of α-Gal and gelatin testing raise the possibility that α-Gal IgE might be the target of reactivity to gelatin. The pathogenic relationship between tick bites and sensitization to red meat, α-Gal, and gelatin (with or without clinical reactivity) remains uncertain.

PMID:
22480538
PMCID:
PMC3340561
DOI:
10.1016/j.jaci.2012.02.038
[Indexed for MEDLINE]
Free PMC Article

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